导流杂交法检测宫颈病变中人乳头瘤病毒的基因型及其感染的临床意义

目的应用导流杂交基因芯片技术(HybriMax)检测宫颈病变人乳头瘤病毒(HPV)基因型及其感染情况,并探讨其临床意义。方法 296例行导流杂交法HPV分型检测的宫颈病变患者分为正常组(58例)、慢性炎症组(32例)、宫颈上皮内瘤变组(66例,该组再分为3个亚组,CINⅠ级组21例、CINⅡ级组19例、CINⅢ级组26例)、宫颈癌组140例,对每个组HPV的阳性率进行比较。结果 296例受检者中191例患者HPV DNA检测为阳性,阳性率为64.53%;正常组HPV阳性率为18.97%(11/58)、慢性炎症组为25.00%(8/32),CINⅠ级组为28.57%(6/21)、CINⅡ级组为73.68%(14/19)、CINⅢ级组为88.46%(23/26)、宫颈癌组为92.14%(129/140),其中正常组与慢性炎症组及CINⅠ级组差异无统计学意义(P>0.05),正常组HPV阳性率较CINⅡ级组、CINⅢ级组及宫颈癌组低(P<0.05),随病变级别增加HPV阳性率逐渐上升(P<0.05)。宫颈病变患者感染率较高的6种HPV病毒为16、18、58、52、53、33型,其阳性率分别为35.47%(105/296)、10.47%(31/296)、6.42%(19/296)、5.41%(16/296)、3.04%(9/296)、2.70%(8/296)。结论宫颈病变与HPV的感染密切相关,高危型HPV感染是宫颈癌变的重要因素之一,导流杂交基因芯片技术检测HPV,对于筛查、治疗及随访CIN及宫颈癌患者有重要意义。

Clinical Significance of the Detection of Human Papilloma Virus Genotype and Infection in Cervical Lesions With Flow-through Hybridization

Objective To detect human papilloma virus(HPV) genotype and infection in cervical lesions with flow-through hybridization(HybriMax),and to explore its clinical significance.Methods Two hundred and ninety-six patients with cervical cancer who were detected with HybriMax were divided into normal histological manifestation group(58 cases),chronic cervicitis group(32 cases),cervical intraepithelial neoplasia group[21 cases of cervical intraepithelial neoplasia(CIN)Ⅰ,19 cases of CIN Ⅱ,26 cases of CIN Ⅲ] and cervical cancer group(140 cases).The positive rates of HPV infection were compared among five groups.Results There were 191 cases infected with HPV among 296 cases,the positive rate of HPV was 64.53%;The positive rate was 18.97%(11/58) in normal histological manifestation group,25%(8/32) in chronic cervicitis group,28.57%(6/21) in CIN Ⅰ group,73.68%(14/19) in CIN Ⅱ group,88.46%(23/26) in CIN Ⅲ group,92.14%(129/140) in cervical cancer group,there was no statistical significance among normal histological manifestation group,chronic cervicitis group and CIN Ⅰ group(P>0.05),the positive rate of HPV was lower in normal histological manifestation group than in CIN Ⅱ group,CIN Ⅲ group,cervical cancer group(P<0.05).The positive rate of HPV increased with the severity of cervical lesion(P<0.05).The six most common genotypes in cervical lesion patients with high infection rate were:type 16,18,58,52,53,33,with the positive rate of 35.47%(105/296),10.47%(31/296),6.42%(19/296),5.41%(16/296),3.04%(9/296),2.70%(8/296),respectively.Conclusion Cervical lesion is closely related with HPV infection,and high-oncogenic risk HPV infection is an important factor of cervical cancer.HybriMax has important significance for the screening,treatment,and follow-up of CIN and cervical cancer.